I honestly can't remember how long after a dose it took for the (sexual) effects to become apparent That was over a year ago. And, I'm not certain how consistently one would have to use this (or bromo) before such effects become noticeable.

Sonic:

I'm not sure how wise it would be to take YHCL along with a SSRI (as I assume you're using this for some anxiety disorder). YHCL is rather nasty in terms of such side-effects, and I've dealt with YHCL induced anxiety attacks one too many times.

Vitex, or bromo, may be more suitable options in your case, as stand-alones.

Sonic, what dose did you try the yohimbe at and at what timing? Dante is correct, did not think of the sides of yohimbe but for some reason at night before sex my anxiety levels just do not seem to go up! For me the 10mg dose works fine, for a smaller bodyweight a much smaller dose would most likely be in order. When i take it for fat burning, 20mg has more of a "punch" and is more likely to produce anxiety. As a side note, when we make love, i always bring my wife to orgasm before we even start intercourse, she has always maintained that she has two kinds of orgasm, a pre-coitus and during coitus orgasm.

Dante: I would never take bromo for anything having had some fairly severe side effects from it, primarily orthostatic hypotension.

I took 3 mg about an hour before we had sex - I'm fairly sensitive to its effects, 3 mg is plenty for me. I think 20 would kill me

The sex was great, but it didn't affect the SSRI orgasmic inhibition in any way. In a way, it made things worse, to get to 99% even faster, but to not be able to get all the way was a kind of torture!

I tried Viagra once too - the thing is, Viagra and yohimbe create erections but that isn't the problem with SSRI inhibition. They're solutions to the wrong problem - I've heard that serotonin inhibitors work, but I'm not aware of anything fast acting and short-lived. I even tried Periactin, which is an antihistamine that is supposedly a serotonin inhibitor, no luck.

So I gave up the SSRIs Whoever invents a solution to this problem is going to be very very very rich!!!!

I don't think there is a solution to the problem of SSRI induced sexual dysfunction because (1) the mechanism isn't really understood and (2) individual responses to the different drugs are so variable. Nytol's experience is a classic case: overall Prozac has a higher incidence of sexual dysfunction than does citalopram, yet Nytol did better on the former.

When psychiatrists were polled about how they manage SSRI induced sexual dysfunction, 43% said they would add bupropion, while 36% said they would switch agents as their first choice. So the experts are clearly divided.

Department of Clinical and Experimental Endocrinology, University of Gottingen, Germany. ufkendo@med.uni-goettingen.de

Extracts of the fruits of chaste tree (Vitex agnus castus = AC) are widely used to treat premenstrual symptoms. Double-blind placebo-controlled studies indicate that one of the most common premenstrual symptoms, i.e. premenstrual mastodynia (mastalgia) is beneficially influenced by an AC extract. In addition, numerous less rigidly controlled studies indicate that AC extracts have also beneficial effects on other psychic and somatic symptoms of the PMS. Premenstrual mastodynia is most likely due to a latent hyperprolactinemia, i.e. patients release more than physiologic amounts of prolactin in response to stressful situations and during deep sleep phases which appear to stimulate the mammary gland. Premenstrually this unphysiological prolactin release is so high that the serum prolactin levels often approach heights which are misinterpreted as prolactinomas. Since AC extracts were shown to have beneficial effects on premenstrual mastodynia serum prolactin levels in such patients were also studied in one double-blind, placebo-controlled clinical study. Serum prolactin levels were indeed reduced in the patients treated with the extract. The search for the prolactin-suppressive principle(s) yielded a number of compounds with dopaminergic properties: they bound to recombinant DA2-receptor protein and suppressed prolactin release from cultivated lactotrophs as well as in animal experiments. The search for the chemical identity of the dopaminergic compounds resulted in isolation of a number of diterpenes of which some clerodadienols were most important for the prolactin-suppressive effects. They were almost identical in their prolactin-suppressive properties than dopamine itself. Hence, it is concluded that dopaminergic compounds present in Vitex agnus castus are clinically the important compoun

Nandi-- interesting stat on what psychiatrists do to counter the sexual s/e's of SSRI's. Some of my clients report positive outcome from this--but not the majority. Psychiatrists have also used the SSRI's and occasionally a mood stabilizers on several of my clients who manifest compulsive sexuality. Surprisingly, this leaves them with erectile dysfunction or unable to orgasm when having sex with a partner but not when they masterbate. As a clinician. I obviously have too limited a sample to make many reliable observations about what's going. However, I have a better treatment outcome when I challenge the diagnosis (ie bipolar d.o.) in instances where no more than hypersexuality is involved and reducing or eliminating the medications. It seems that feeling sexual and performing more successfully with partners is a signficant factor to treatment. And yes! I have to deal with signficant resistance from the client, psychiatrist, and spouses.

As sort of an aside, headdoc, I live in Utah where we obviously have a big LDS (Mormon) population. The majority of kids get married quite young and most have had few if any sexual experiences. Even masturbation is considered the devil's work. Premature ejaculation is consequently a big problem for these young married couples, and since the men do not have a clue as to things like stimulating their spouse to orgasm then having intercourse, or reversing the sequence, or whatever works best to provide mutual satisfaction, this is a problem that leads to marital difficulties in large numbers of couples. The typical solution of course is to confide in one's GP who then prescribes an SSRI to delay time to ejaculation. And as you point out, it typically backfires. What a disaster. It seems like some basic sex education would be a much better solution.

The majority of sex addicts I treat here in Phoenix have either Catholic or Mormon backgrounds. If you or the others posting on the topic of SSRI sexual se/s come up with anything useful please post it all over this board or Avant so I can share it. The two already mentioned are worth a try. One other possibility would involve titrating the SSRI as the severity of the syx. decline and replaicng it with Buproprion altogether. I also wonder if the high doses (12 gms.) of inositol brings on sexual s/e's?